On top of that, invasive hemodynamic measurement requires surgical technique and a considerable time is necessary in learning variable analysis.15) Taken together, use of non-invasive method can be a useful modality for serial follow up of cardiac functions in development of treatment for DMCMP and we expect that this will be helpful in saving
tremendous cost and time for the development of medication for DMCMP. Acknowledgements This study was supported by grant from Korea Research Foundation (KRF, E00217) and grant from the SNUH research fund (03-2007-0240).
Carbon #Cyclosporin A solubility dmso keyword# monoxide (CO) can cause functional and morphological alternations of the heart mainly due to myocardial hypoxemia and direct action of CO on the heart.1),2) CO has about 250-fold higher affinity for hemoglobin as
compared to oxygen and forms Inhibitors,research,lifescience,medical carboxyhemoglobin (CO-Hb). In the presence of CO-Hb, a leftward shift of the oxygenated hemoglobin dissociation curve observed and leads to impairment of tissue oxygen delivery and makes cellular hypoxia.1) CO induced cardiotoxicity has many clinical manifestations including arrhythmias, pulmonary edema and heart failure, and myocardial Inhibitors,research,lifescience,medical infarction. Echocardiography is known as the most useful method in the detection the presence of cardiac toxicity and assessment of its severity. We report a case with transient severe left ventricular dysfunction after intentional exposure to CO. The patient was early detected with an echocardiographic exam and treated with conventional treatment including high concentration of oxygen. Case A 28-year-old man was admitted to our emergency room for altered mentality due to intentional exposure to CO. On his arrival, blood Inhibitors,research,lifescience,medical pressure was 104/80 mmHg, the pulse 126 beat per minute, axillary temperature 37.7℃ and the respirations were 32 breaths per minute. On blood analysis, AST/ALT 37/29 IU/L, CK 412 U/L, CK-MB 6.9 ng/mL, troponin I 0.96 ng/mL, N-terminal pro B-type natriuretic peptide 451.5 pg/mL, and CO-Hb 27.7%. The patient was intubated and treated with high concentration of oxygen therapy. A radiograph of the chest showed pulmonary edema and mild cardiomegaly Inhibitors,research,lifescience,medical (Fig. 1A). An electrocardiogram
revealed sinus tachycardia of heart rate 120 per minute. Transthoracic echocardiogram showed global hypokinesia of left ventricle with severe systolic dysfunction (Fig. 2A and B). He was treated with diuretics, angiotensin converting enzyme inhibitor and urine alkalinization. Montelukast Sodium Cardiac enzymes were elevated to CK 5,994 U/L, CK-MB 38.6 ng/mL, and troponin I 11.7 ng/mL on the third admission day. CK level was elevated to 15,951 U/L due to rhabdomyolysis and normalized with urine alkalinization. The follow-up chest radiograph showed normalized cardiac size and disappearance of pulmonary edema (Fig. 1B). The echocardiography taken after four days of treatment revealed normalized left ventricular systolic function (Fig. 2C and D). The patient discharged without any complication.